Type of study


Harris EE, et al. 2005 [24]

Retrospective 278 patients

No clinical impact on cosmesis, complication either modality:

No comments on CON V SEQ

Azria D, et al. 2005 [25]

Commentary (retrospective data)

“Concurrent” increases subcutaneous and pulmonary fibrosis

Azria D, et al. 2004 [26]

Retrospective 147 patients

“Concomitant”-Tamoxifen (Tam) increases sub-cut breast fibrosis

in hypersensitive patients

Whelan T, et al. 2005 [27]

Editorial review

SEQ or CON: yet to be resolved Randomized trial recommended

Pierce LJ, et al. 2005 [28]

Prospective randomized, 309 pts

No difference in adverse effect, local or systemic recurrence

RT + TAM or RT only

Ismail SS, et al. 2013 [29]

Prospective 160 patients

No difference RT + CON or SEQ

Bentzen SM, et al. 1996 [30]

Retrospective 84 patients

Increase in lung fibrosis in CON Group

Ishitobi M, et al. 2009 [31]

Retrospective 264 patients

No difference between CON and SEQ Group

Tsoutsou PG, et al. 2010 [32]


May be given CON or SEQ (RT) Combination of Tamoxifen

and Letrozole recommended

Ahn PH, et al. 2005 [33]

Retrospective 495 patients

CON did not affect local control No observation on cosmesis

and toxicity

Koc M, et al. 2002 [34]

Prospective 111 patients

RT + TAM V RT + 0: Tele cobalt RT Significant risk of lung

fibrosis. No comment on CON V SEQ

Cecchini MJ, et al. 2015 [35]

Literature review

SEQ supported due to increase in lung fibrosis in CON treatment

Munshi A, et al. 2011 [36]

Randomized prospective

Results awaited (major study)